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Journal of Bone and Joint Surgery - British Volume, Vol 89-B, Issue 2, 196-201.
doi: 10.1302/0301-620X.89B2.18059  
Copyright © 2007 by British Editorial Society of Bone and Joint Surgery
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Proximal scaphoid rib graft arthroplasty

S. Veitch, MD, MRCS, Orthopaedic Specialist Registrar1; S. M. Blake, BSc, MBBS, MRCS, Orthopaedic Specialist Registrar2; and H. David, FRCS, FRCS(Orth), Consultant Orthopaedic Surgeon3

1 Princess Elizabeth Orthopaedic Centre, Royal Devon and Exeter Hospital, Barrack Road, Exeter, EX2 5DW, UK.
2 Department of Orthopaedic Surgery, Torbay Hospital, Newton Road, Torquay, Devon TQ2 7AA, UK.
3 Derriford Hospital, Derriford Road, Crownhill, Plymouth, PL6 8DH, UK.

Correspondence should be sent to Dr S. Veitch; e-mail: swveitch{at}doctors.org.uk

We prospectively reviewed 14 patients with deficiency of the proximal pole of the scaphoid who were treated by rib osteochondral replacement arthroplasty.

Improvement in wrist function occurred in all except one patient with enhanced grip strength, less pain and maintenance of wrist movement. In 13 patients wrist function was rated as good or excellent according to the modified wrist function score of Green and O’Brien. The mean pre-operative score of 54 (35 to 80) rose to 79 (50 to 90) at review at a mean of 64 months (27 to 103). Carpal alignment did not deteriorate in any patient and there were no cases of nonunion or significant complications.

This procedure can restore the mechanical integrity of the proximal pole of the scaphoid satisfactorily and maintain wrist movement while avoiding the potential complications of alternative replacement arthroplasty techniques and problems associated with vascularised grafts and salvage techniques.




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D. M. Weber, R. Fricker, and L. E. Ramseier
Conservative treatment of scaphoid nonunion in children and adolescents
J Bone Joint Surg Br, September 1, 2009; 91-B(9): 1213 - 1216.
[Abstract] [Full Text] [PDF]


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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General